<p>Job Summary:</p> <p>Work as a member of the Emerging Communities team to engage gay men and MSM, who are Black, Hispanic, Indigenous, or People of Color living with HIV, who are newly diagnosed and those who are sporadically engaged or who have fallen out of HIV care. Provide case management services with the goal of improved health outcomes. Link and retain clients in health care and assist them to maintain antiretroviral therapy to maximize viral load suppression so they remain healthy and prevent further transmission. Develop and implement creative strategies to recruit and retain clients in services.</p> <p>Major Activities:</p> <ul> <li>Incorporate best practices regarding confidentiality into all job duties and communications in accordance with Article 27-F, HIPAA, Alliance for Positive Health policies and procedures and other applicable regulations. </li><li>Work with the other members of an interdisciplinary team to engage clients in care, treatment and support services. </li><li>Participate in case conferences. Provide coordination, guidance, and assistance to clients in accessing medical, social, community, legal, financial, employment, vocational, and/or other needed services. </li><li>Screen for and address any Social Determinants of Health (SDOH) barriers to HIV care. </li><li>Provide curricula-based individual and group health education sessions that focus on strategies for achieving positive health outcomes and assist individuals living with HIV to build self-management skills. </li><li>Recruit and engage individuals living with HIV who are not in care or sporadically in care. Screen and assess for areas of need and program eligibility. </li><li>Employ techniques to actively support clients in activities that improve their health outcomes resulting in sustained viral load suppression. </li><li>Address and remove barriers to enable client access to all necessary components of health care. Conduct home visits and/or meet clients at designated service providers and community locations to increase accessibility. </li><li>Develop and implement creative strategies to recruit and retain clients in services. </li><li>Incorporate the Transtheoretical Model of Behavior Change, as applicable, into all aspects of programming. </li><li>Collect, maintain, and report up to date client health indicator, contact, and history data. Utilize indicator data to address barriers and improve individual health outcomes. Implement strategies to communicate client health information among internal and external interdisciplinary teams </li><li>Negotiate and advocate on behalf of clients for services that support self-sufficiency and self-management. </li><li>Maintain accurate records in accordance with funder requirements and agency protocols. Maintain documentation and statistics on activities to comply with reporting requirements. </li><li>Perform other duties as assigned. </li></ul> <p>Qualifications:</p> <ul> <li>Bachelor's Degree in Human Services preferred, Associates Degree in Public Health or related field required and two years of human service experience. </li><li>Familiarity with regional HIV primary care, mental health, substance abuse and other services and resources. </li><li>Possess an understanding of community level work and the importance of collaborating and coordinating with other organizations. </li><li>Experience facilitating health education services </li><li>Must have a valid unrestricted driver's license and have a vehicle to travel to designated appointment sites within a multi-county region. </li><li>Ability to work flexible hours if needed, to increase access to services. </li></ul> <p>Knowledge, Skills and Abilities Required:</p> <ul> <li>Effective communication and documentation skills. </li><li>Strong community liaison skills. </li><li>Attention to detail; well organized; good time management skills. </li><li>Ability to maintain professional boundaries within agency and grant guidelines, as well as with clients and external service providers. </li><li>Ability to recruit in the community to reach the target demographic </li><li>Ability to maintain client files and ensure documentation is up to date. </li><li>Ability to interact with people from diverse backgrounds within a climate of mutual respect, inclusion, enrichment, and growth. </li></ul>